Change search
ReferencesLink to record
Permanent link

Direct link
Management of patients with chronic obstructive pulmonary disease in primary health care: a study of a nurse-led multidisciplinary programme of pulmonary rehabilitation
Örebro University, School of Health and Medical Sciences.
2011 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The aim of this thesis was to modify and evaluate effects, as well as todescribe experiences of a nurse-led multidisciplinary programme of pulmonaryrehabilitation in primary health care for patients with chronicobstructive pulmonary disease (COPD) and their next of kin.Interviews were performed with 12 COPD nurses about their experiencesof patient education (I). Forty-nine patients participated in the interventiongroup and 54 in the control group in a quasi-experimentalstudy which investigated the effects of the programme on functional capacity,quality of life and exacerbation frequency during one year (II).Interviews were performed related to the experiences of 20 patients whohad participated in the six-week programme (III) and the experiences of20 next of kin to the patients that had participated (IV).The results showed that COPD nurses fluctuated between security andinsecurity in patient education and were in need of support, time, structureand collaboration to develop their patient education (I). In Study IIthere were no differences between the groups with regard to functionalcapacity and quality of life, but the number of exacerbations decreased inthe intervention group and increased in the control group (II). The patientsin study III had allowed themselves to live at their own pace followingthe programme but a constant fear was present in spite of the programme(III). Next of kin in Study IV had a life that remained overshadowedby illness but there were positive outcomes of the programme aslong as two years afterwards. The next of kin also had constant fear,however (IV).In conclusion, the six week programme brought about results in changingeveryday life. Nevertheless, all lived in the shadow of fear and uncertaintyin spite of the programme. More research is needed to address therequirements of COPD nurses, patients and next of kin.

Place, publisher, year, edition, pages
Örebro: Örebro universitet , 2011. , 82 p.
Series
Örebro Studies in Medicine, ISSN 1652-4063 ; 59
Keyword [en]
COPD, exacerbations, experiences, functional capacity, next of kin, nursing care, primary care, quality of life
National Category
Health Sciences Nursing
Research subject
Nursing Science
Identifiers
URN: urn:nbn:se:oru:diva-15732ISBN: 978-91-7668-819-9OAI: oai:DiVA.org:oru-15732DiVA: diva2:419692
Public defence
2011-11-18, Wilandersalen, Universitetssjukhuset, Örebro, 13:00
Opponent
Supervisors
Available from: 2011-05-27 Created: 2011-05-27 Last updated: 2011-12-05Bibliographically approved
List of papers
1. The asthma/COPD nurses’ experience of educating patients with chronic obstructive pulmonary disease in primary health care
Open this publication in new window or tab >>The asthma/COPD nurses’ experience of educating patients with chronic obstructive pulmonary disease in primary health care
2010 (English)In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 24, no 1, 147-155 p.Article in journal (Refereed) Published
Abstract [en]

The number of patients with chronic obstructive pulmonary disease (COPD) is increasing. These patients need nursing care, including education in self-care, which has a positive effect on their physical and psychoemotional well-being. The aim of this study was to describe the experiences of asthma/COPD nurses' in primary health care (PHC) of educating patients with COPD. A descriptive, qualitative study was conducted, with interviews of 12 asthma/COPD nurses. The data were analysed using qualitative content analysis. The findings are presented in two themes: Theme 1, receiving support results in a feeling of security, which enables the development of patient education; and Theme 2, a lack of support results in a feeling of insecurity, which makes it difficult to develop patient education. The asthma/COPD nurses were individual orientated with individualization of care, but the patient's mood, the varying support of those around and the nurses' varying degrees of security affected the education. The conclusion is that the asthma/COPD nurses' experience of patient education fluctuated between insecurity and security. The nurses' feeling of insecurity in their patient education can be strengthened through support from colleagues and by increased knowledge in promoting the learning of others. Collaborative teamwork with a well-functioning asthma/COPD clinic in PHC can facilitate and improve patient services; these initiatives can enable the asthma/COPD nurses to reach their full potential.

Place, publisher, year, edition, pages
Wiley-Blackwell, 2010
Keyword
chronic obstructive pulmonary disease, district nurse, nursing, patient education, primary health care, self-care
National Category
Nursing
Research subject
Nursing Science
Identifiers
urn:nbn:se:oru:diva-20123 (URN)10.1111/j.1471-6712.2009.00698.x (DOI)000274389900019 ()
Available from: 2011-10-19 Created: 2011-10-19 Last updated: 2012-08-06Bibliographically approved
2. Nurse-led multidisciplinary programme for patients with COPD in primary health care: a controlled trial
Open this publication in new window or tab >>Nurse-led multidisciplinary programme for patients with COPD in primary health care: a controlled trial
Show others...
2011 (English)In: Primary Care Respiratory Journal, ISSN 1471-4418, E-ISSN 1475-1534, Vol. 20, no 4, 427-433 p.Article in journal, Letter (Refereed) Published
Abstract [en]

AIM:To investigate the effects of a nurse-led multidisciplinary programme (NMP) of pulmonary rehabilitation in primary health care with regard to functional capacity, quality of life (QoL), and exacerbations among patients with chronic obstructive pulmonary disease (COPD).

METHOD:A 1-year longitudinal study with a quasi-experimental design was undertaken in patients with COPD, 49 in the intervention group and 54 in the control group. Functional capacity was assessed using the 6-minute walking test, and quality of life (QoL) was assessed using the Clinical COPD Questionnaire. Exacerbations were calculated by examination of patient records.

RESULTS:No significant differences were found between the groups in functional capacity and QoL after 1 year. The exacerbations decreased in the intervention group (n = -0.2) and increased in the control group (n = 0.3) during the year after NMP. The mean difference of change in exacerbation frequency between the groups was statistically significant after one year (p=0.009).

CONCLUSIONS:The NMP in primary care produced a significant reduction in exacerbation frequency, but functional capacity and QoL were unchanged. More and larger studies are needed to evaluate potential benefits in functional capacity and QoL.

Keyword
COPD, management, exacerbations, nurse, primary care, rehabilitation, pulmonary, quantitative
National Category
Nursing
Research subject
Nursing Science
Identifiers
urn:nbn:se:oru:diva-20124 (URN)10.4104/pcrj.2011.00060 (DOI)21687920 (PubMedID)
Note

The authors are also affiliated to Family Medicine Research Centre, Örebro University, Sweden • Centre for Assessment of Medical Technology in Örebro, Sweden.

Available from: 2011-10-19 Created: 2011-10-19 Last updated: 2016-12-02Bibliographically approved
3. Experiences among patients with COPD one year after attending a primary care nurse-led multidisciplinary programme
Open this publication in new window or tab >>Experiences among patients with COPD one year after attending a primary care nurse-led multidisciplinary programme
(English)Manuscript (preprint) (Other academic)
National Category
Nursing
Research subject
Nursing Science
Identifiers
urn:nbn:se:oru:diva-20125 (URN)
Available from: 2011-10-19 Created: 2011-10-19 Last updated: 2016-11-30Bibliographically approved
4. Next of kin’s experience of living with a patient suffering from COPD two years after a nurse-led multidisciplinary programme of pulmonary rehabilitation in primary health care settings
Open this publication in new window or tab >>Next of kin’s experience of living with a patient suffering from COPD two years after a nurse-led multidisciplinary programme of pulmonary rehabilitation in primary health care settings
(English)Manuscript (preprint) (Other academic)
National Category
Nursing
Research subject
Nursing Science
Identifiers
urn:nbn:se:oru:diva-20126 (URN)
Available from: 2011-10-19 Created: 2011-10-19 Last updated: 2016-11-30Bibliographically approved

Open Access in DiVA

fulltext(5749 kB)2157 downloads
File information
File name FULLTEXT02.pdfFile size 5749 kBChecksum SHA-512
6bcdacad1191ab59def1547c58f8446c48e233f098a7b3e98bd672eeca7ab7c9882f602c23713fc389fe622e807901ceb60340982d7c72e4d4169f2c01b1d38b
Type fulltextMimetype application/pdf
omslag(1636 kB)95 downloads
File information
File name COVER01.pdfFile size 1636 kBChecksum SHA-512
05ca70b3c39335fe2109a6fc6eacd4073db43c6989c2f1241aa9fe98ce1d04465844a22a671807da0b2279dea41c246ab1b163a553d13b2589b1d0f1db9f15c0
Type coverMimetype application/pdf
spikblad(69 kB)11 downloads
File information
File name SPIKBLAD01.pdfFile size 69 kBChecksum SHA-512
7b4bcd15b2479a414ffb42cef9ab0d807c760d48c6f9314af0137f10069f8786731c55072641a56c6a51a8e1a2c2c41e4540dc7e3ea31e56bda03f47faa5bd61
Type spikbladMimetype application/pdf

Search in DiVA

By author/editor
Zakrisson, Ann-Britt
By organisation
School of Health and Medical Sciences
Health SciencesNursing

Search outside of DiVA

GoogleGoogle Scholar
Total: 2157 downloads
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

Total: 877 hits
ReferencesLink to record
Permanent link

Direct link